The ‘R’ Facelift

Procedure

This is a modified method developed by Mr Riaz during the last couple of years. This method was developed in a particular patient who had Ehler’s Danlos Syndrome (EDS).

These patients have a tendency of severe bleeding and bruising and poor healing. This technique involves a pre-operative assessment for skin laxity, and the area of skin to be excised is assessed and marked. This technique has a similar scar as in the MACS facelift, which is around the sideburn, in front of the ear and stops behind the ear.

Intraoperative view of one of the skin excisions

There is pre-excision of skin and fat down to SMAS without any undermining of skin. Therefore there is no bruising of the skin of the cheek and neck after this type of facelift. It can be combined with liposuction of fat under the chin and upper part of the neck. Deep sutures are used to plicate the exposed SMAS. The central concept of this technique is called the composite lift.

The soft tissue of the cheek and neck is lifted in a vertical direction by anchoring the lifting sutures to fixed points above the cheek bone to the temple. This procedure is different to a skin excision only because skin approximation is not dependent on skin closure sutures.

This technique does not require any drains or post-operative pressure dressings. There is a very short down time. The technique itself, as presented in the meeting of British Association of Aesthetic Plastic Surgeons in September 2014.